Table 2.

ASL vs. DSA comparison; assessment of ASL limitation.

Characteristics Analyzed	Advantages of ASL	Advantages of DSA	Disadvantages of ASL	Disadvantages of DSA
Endogenous Tracer Usage (water)	++	−	−	Contrast agent required; risk of complications
Safety as a Noninvasive Alternative	+	−	−	Invasive procedure; potential for vascular complications
Functional AVM Assessment	Provides functional assessment	−	Reduced reliability for venous drainage assessment (spin inversion)	Limited functional information; anatomical focus
Identification of Arterial Feeders	−/+	−	Difficulty in detecting AVMs in specific locations	Excellent identification of arterial feeders; comprehensive view
Characterization of Low-Flow Segments	−	−	Underestimation of total blood flow in AVMs	May not provide detailed information on low-flow segments
Mitigation of Overestimation Risk	−/+	−	Limitations in the immediate postintervention period	Potential for overestimation due to strong contrast agent injection
Identification Despite Mass Effect	−	−	Challenges in interpretation due to inhomogeneities	Excellent for overcoming mass effect; direct visualization

+ (moderate advantages), ++ (strong advantages), −/+ (indifferente) and – (not reported).